Sustainable models and economics of health care

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Published: 22 Nov 2013
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Dr Felicia Marie Knaul - Harvard Global Equity Initiative, USA

Dr Felicia Marie Knaul speaks to ecancertv about the “diagonal approach” at the 5th International Cancer Control Congress in Lima, Peru. Using the “diagonal approach,” the reach of cancer control can be extended into secondary care and beyond. In the case of Latin American women, efforts such as maternity health programs have diagonal effects on breast and cervical cancer awareness, diagnosis and outcome.

5th International Cancer Control Congress

Sustainable models and economics of health care

Dr Felicia Marie Knaul - Harvard Global Equity Initiative, USA


Thank you to ecancer and I’m just thrilled to be in Latin America, that ecancer is working so much in Latin America and this wonderful conference because it really goes from north to south in terms of it’s really the Americas. So it’s an opportunity where we’re sharing Canadian, US-based researchers and researchers throughout the Latin America region to understand a little bit better how we can combat what is cancer as a chronic illness, one of the leading causes of death and disability in all of our regions, not only in Canada and the United States but going from Mexico on down to the tip and across Central America we’re seeing increasing rates. It’s simply part of a process of economic and social development.

So in the session tomorrow we’ll be talking about effective approaches and I’ll be discussing the diagonal approach which is how you take advantage of horizontal interventions of platforms and health systems like anti-poverty programmes or maternal and child health programmes to be able to extend our reach in terms of cancer control and also cancer treatment. So all across the spectrum, the continuum from primary, secondary prevention on to treatment, survivorship, care and pain and palliation can be inserted within other programmes that already are reaching out to many, many people and particularly to women. We find that the insertion of information about effective care and control of cervical and breast cancer in maternal and child health or anti-poverty programmes have been incredibly important. I’ll be speaking specifically about our experience in Mexico; I’ll be speaking there as the leader of Tómatelo a Pecho, an NGO based in Mexico, and also the Mexican Health Foundation where I’m Senior Economist. There I’ll be sharing what has been done with the Seguro Popular, a very innovative financial programme in Mexico that is now covering 54.6 million people. So basically all of the population that does not have access to social security, which is why we’ve talked about it in a Lancet article last year in August of 2012 that Mexico really has reached universal health coverage. Tomorrow I’ll be disentangling a little bit what that means for cancer, how different cancers have been included in the catastrophic fund and how there is still an enormous challenge for delivery. This is this delivery failure that Jim Kim from the World Bank has been speaking about repeatedly in terms of many of our programmes, that we have treatment covered but we absolutely have to be doing more on earlier detection which means sharing information which means an all of society approach so that when women are arriving, for example, for breast cancer treatment they’re not arriving in stage 3 which is what we’re typically seeing, 3 or 4, 60-70% of our cases arriving so late that we’re spending a tremendous amount on treatment without much hope of extending life or quality of life. So we really need to downstage and that’s what we’re going to be working on, talking about that whole system strengthening approach tomorrow.